Outcome of pulmonary and aortic allografts for reconstruction of the right ventricular outflow tract in congenital cardiac surgery
| Autor: | J. C. Haehnel, J. Weipert, H. Meisner |
|---|---|
| Rok vydání: | 1997 |
| Předmět: |
medicine.medical_specialty
business.industry medicine.disease Surgery Cardiac surgery surgical procedures operative medicine.anatomical_structure Great arteries Ventricle Double outlet right ventricle Internal medicine medicine.artery Pulmonary artery medicine Cardiology Ventricular outflow tract Pulmonary atresia business Tetralogy of Fallot |
| Zdroj: | Cardiac Valve Allografts ISBN: 9783642639159 |
| DOI: | 10.1007/978-3-642-59250-8_27 |
| Popis: | Between July 1982 and September 1995, a total of 280 patients (median age 6.4 years, range 1 month to 46 years, 68 patients younger than 1 year) underwent repair of the right ventricle to pulmonary artery connection by insertion of an allograft. The diagnoses were truncus arteriosus communis (n = 84, 30.0%), tetralogy of Fallot (n = 62, 22.1%), pulmonary atresia (n = 76, 27.1%), double outlet right ventricle (n = 13, 4.6%), complex transposition of the great arteries with pulmonary stenosis (n = 31, 11.1%), and others (n = 14, 5.1%). Either pulmonary (n = 82) or aortic (n = 198) cadaver allografts were implanted. Results: Follow-up was complete for 95.4% (n = 267, 1497 patient years). Thirty-day mortality was 13.2% (n = 37), late mortality 3.2% (n = 9). Kaplan-Meier analysis revealed that 64.0% patients with allograft valve diameter less than 15.0 mm underwent replacement of their conduit within 7 years, because these patients had outgrown their conduits. When the allograft was larger than 15.0 mm exchange was necessary in 17% at 10 years. Blood group compatibility and aortic or pulmonary origin of the allograft had no significant influence on allograft survival. Conclusion: 1) if it is possible to implant allografts with diameters greater than 15.0 mm, allografts of either pulmonary or aortic origin are the grafts of choice for restoration of the right ventricle to pulmonary artery continuation; and 2) 64.0% of the allografts with diameters less than 15.0 mm will require reoperation within 7 years. In these patients, xenograft implantation may also be indicated. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|